Systems and methods for using registered fluoroscopic images in image-guided surgery

Abstract

A method performed by a computing system comprises receiving a fluoroscopic image of a patient anatomy while a portion of a medical instrument is positioned within the patient anatomy. The fluoroscopic image has a fluoroscopic frame of reference. The portion has a sensed position and sensed orientation in an anatomic model frame of reference. The method further comprises identifying the portion in the fluoroscopic image and identifying an extracted position and an extracted orientation of the portion in the fluoroscopic frame of reference using the identified portion in the fluoroscopic image. The method further comprises registering the fluoroscopic frame of reference to the anatomic model frame of reference based on the sensed position of the portion, the extracted position of the portion, the sensed orientation of the portion, and the extracted orientation of the portion.

What is claimed is: 
     
       1. A method performed by a computing system comprising:
 receiving a fluoroscopic image of a patient anatomy while a portion of a medical instrument is positioned within the patient anatomy, the fluoroscopic image having a fluoroscopic frame of reference, wherein the portion has a sensed position in an anatomic model frame of reference; 
 identifying the portion in the fluoroscopic image; 
 identifying an extracted position of the portion in the fluoroscopic frame of reference using the identified portion in the fluoroscopic image; 
 registering the fluoroscopic frame of reference to the anatomic model frame of reference based on the sensed position of the portion and the extracted position of the portion; and 
 identifying an extracted orientation of the portion in the fluoroscopic frame of reference using the identified portion in the fluoroscopic image, 
 wherein the portion has a sensed orientation in the anatomic model frame of reference, and 
 wherein registering the fluoroscopic frame of reference to the anatomic model frame of reference is further based on the sensed orientation of the portion and the extracted orientation of the portion. 
 
     
     
       2. The method of  claim 1 , wherein identifying the portion in the fluoroscopic image includes identifying an expected shape of the portion in the fluoroscopic image. 
     
     
       3. The method of  claim 1 , wherein identifying the portion in the fluoroscopic image includes comparing the fluoroscopic image of the patient anatomy while the portion of the medical instrument is positioned within the patient anatomy to a fluoroscopic image of the patient anatomy recorded when the portion of the medical instrument is not positioned within the patient anatomy. 
     
     
       4. A method performed by a computing system comprising:
 receiving a fluoroscopic image of a patient anatomy while a portion of a medical instrument is positioned within the patient anatomy, the fluoroscopic image having a fluoroscopic frame of reference, wherein the portion has a sensed position in an anatomic model frame of reference; 
 identifying the portion in the fluoroscopic image; 
 identifying an extracted position of the portion in the fluoroscopic frame of reference using the identified portion in the fluoroscopic image; and 
 registering the fluoroscopic frame of reference to the anatomic model frame of reference based on the sensed position of the portion and the extracted position of the portion, wherein identifying the portion in the fluoroscopic image includes comparing the fluoroscopic image of the patient anatomy while the portion of the medical instrument is positioned at a first location within the patient anatomy to a fluoroscopic image of the patient anatomy recorded when the portion of the medical instrument is positioned at a second location within the patient anatomy. 
 
     
     
       5. The method of  claim 4 , further comprising receiving a set of model points for an anatomic model of passageways of the patient anatomy in the anatomic model frame of reference. 
     
     
       6. The method of  claim 5 , wherein the set of model points for an anatomic model of passageways is developed from a computerized tomography scan. 
     
     
       7. The method of  claim 5 , further comprising displaying the portion of the medical instrument within a co-registered image of a portion of the fluoroscopic image and a portion of the anatomic model. 
     
     
       8. The method of  claim 7 , further comprising:
 identifying and displaying a target tissue within the anatomic model; and 
 overlaying the target tissue in the co-registered image of the portion of the fluoroscopic image. 
 
     
     
       9. The method of  claim 8 , further comprising:
 planning a path to the target tissue in the anatomic model; and 
 overlaying the path in the co-registered image of the portion of the fluoroscopic image. 
 
     
     
       10. A method performed by a computing system comprising:
 receiving a fluoroscopic image of a patient anatomy while a portion of a medical instrument is positioned within the patient anatomy, the fluoroscopic image having a fluoroscopic frame of reference, wherein the portion has a sensed position in an anatomic model frame of reference; 
 identifying the portion in the fluoroscopic image; 
 identifying an extracted position of the portion in the fluoroscopic frame of reference using the identified portion in the fluoroscopic image; 
 registering the fluoroscopic frame of reference to the anatomic model frame of reference based on the sensed position of the portion and the extracted position of the portion; 
 receiving sensor position information from a position sensor of the medical instrument to determine the sensed position of the portion of the medical instrument, wherein the sensor position information is in a sensor frame of reference; 
 registering the anatomic model frame of reference and the sensor frame of reference, wherein the anatomic model frame of reference is associated with an anatomic model of anatomic passageways of the patient anatomy; and 
 determining, from the registration of the anatomic model frame of reference and the sensor frame of reference, the sensed position of the portion in the anatomic model frame of reference. 
 
     
     
       11. The method of  claim 10 , wherein the position sensor is an optical fiber shape sensor extending along the medical instrument. 
     
     
       12. The method of  claim 10 , wherein determining the sensed position of the portion of the medical instrument in the anatomic model frame of reference includes referencing a set of coordinates of the sensor position information in the sensor frame of reference with a corresponding set of coordinates in the anatomic model frame of reference. 
     
     
       13. The method of  claim 10 , wherein registering the anatomic model frame of reference and the sensor frame of reference includes:
 receiving a set of model points of the anatomic model; 
 receiving a set of measured points collected from within the anatomic passageways, each point comprising coordinates within the sensor frame of reference; 
 matching measured points of the set of measured points to model points of the set of model points to generate a set of matches; and 
 moving the set of measured points relative to the set of model points based upon the set of matches. 
 
     
     
       14. A method performed by a computing system comprising:
 identifying a set of positions of a plurality of anatomic landmarks, the plurality of anatomic landmarks rendered in an anatomic model of passageways of a patient anatomy in a model frame of reference; 
 receiving fluoroscopic image data of the patient anatomy while a portion of a medical instrument traverses the plurality of anatomic landmarks in the passageways of the patient anatomy, the fluoroscopic image data having a fluoroscopic frame of reference; 
 identifying a set of positions of the portion of the medical instrument at the plurality of anatomic landmarks in the fluoroscopic frame of reference; 
 registering the set of positions of the plurality of anatomic landmarks in the model frame of reference and the set of positions of the portion of the medical instrument at the plurality of anatomic landmarks in the fluoroscopic frame of reference to a common frame of reference; and 
 displaying a co-registered image of a portion of the fluoroscopic image, a portion of the anatomic model, and the portion of the medical instrument. 
 
     
     
       15. The method of  claim 14 , wherein identifying the set of positions of the portion of the medical instrument in the fluoroscopic frame of reference includes identifying a predetermined shape of the portion of the medical instrument in the fluoroscopic frame of reference. 
     
     
       16. The method of  claim 14 , wherein identifying the set of positions of the portion of the medical instrument in the fluoroscopic frame of reference includes comparing the fluoroscopic image data of the patient anatomy while the portion of the medical instrument is positioned at least one of the plurality of landmarks to fluoroscopic image data of the patient anatomy recorded when the portion of the medical instrument is not positioned within the patient anatomy. 
     
     
       17. A method performed by a computing system comprising:
 identifying a set of positions of a plurality of anatomic landmarks, the plurality of anatomic landmarks rendered in an anatomic model of passageways of a patient anatomy in a model frame of reference; 
 receiving fluoroscopic image data of the patient anatomy while a portion of a medical instrument traverses the plurality of anatomic landmarks in the passageways of the patient anatomy, the fluoroscopic image data having a fluoroscopic frame of reference; 
 identifying a set of positions of the portion of the medical instrument at the plurality of anatomic landmarks in the fluoroscopic frame of reference; and 
 registering the set of positions of the plurality of anatomic landmarks in the model frame of reference and the set of positions of the portion of the medical instrument at the plurality of anatomic landmarks in the fluoroscopic frame of reference to a common frame of reference, 
 wherein identifying the set of positions in the fluoroscopic frame of reference includes comparing the fluoroscopic image data of the patient anatomy while the portion of the medical instrument is positioned at least one of the plurality of landmarks to an image of the patient anatomy recorded when the portion of the medical instrument is positioned at another location within the patient anatomy. 
 
     
     
       18. A method performed by a computing system comprising:
 identifying a set of positions of a plurality of anatomic landmarks, the plurality of anatomic landmarks rendered in an anatomic model of passageways of a patient anatomy in a model frame of reference; 
 receiving fluoroscopic image data of the patient anatomy while a portion of a medical instrument traverses the plurality of anatomic landmarks in the passageways of the patient anatomy, the fluoroscopic image data having a fluoroscopic frame of reference; 
 identifying a set of positions of the portion of the medical instrument at the plurality of anatomic landmarks in the fluoroscopic frame of reference; and 
 registering the set of positions of the plurality of anatomic landmarks in the model frame of reference and the set of positions of the portion of the medical instrument at the plurality of anatomic landmarks in the fluoroscopic frame of reference to a common frame of reference, 
 wherein the common frame of reference is the model frame of reference or is the fluoroscopic frame of reference.